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English as a Second Language Health Literacy Program

Community-Based Participatory English as a Second Language Health Literacy Program to Prevent Lead Exposure in Flint

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04125680
Enrollment
17
Registered
2019-10-14
Start date
2021-05-20
Completion date
2021-09-15
Last updated
2023-02-24

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Health Literacy, Language

Brief summary

This research is using a Community-Based Participatory Action Research (CBPAR) approach to design, implement, and evaluate English as a Second Language health literacy classes for Hispanic adults to reduce lead exposure.

Detailed description

This Community-Based Participatory Action Research (CBPAR) aims to: 1. Develop a community-based participatory English as a Second Language (ESL) health literacy curriculum for lead exposure that can be used in other locations or programs. 2. Determine the outcomes of the curriculum, including changes in knowledge about lead, access to health resources, and health behavioral changes to reduce lead exposure. 3. To evaluate the implementation of the ESL health literacy curriculum. This research focuses on ESL health literacy classes provided to Hispanic adults to reduce lead exposure. This research will use a pilot test with a pre-post test design. The program will last for 8 weeks; with weeks 1 and 8 as the assessment weeks. The curriculum uses pedagogies that move participants from health literacy as functional skill to health literacy as social practice where knowledge is used for empowerment and meaningful change. The goals of this research are to demonstrate increased health literacy knowledge, improved health behaviors, increased access to health services, and improved English language proficiency for Hispanic residents of Flint in relation to lead exposure prevention.

Interventions

BEHAVIORALESL Health Literacy Classes

The intervention will last 8-weeks, and the first and last classes will be devoted to survey assessments. Participants will be asked to reflect on their health knowledge and behaviors, and how they have changed since starting the program. The curriculum administered during the classes will use pedagogies for health literacy as a practice. It will focus on skills needed to learn about lead exposure in the ESL classroom: (1) vocabulary; (2) grammar; and (3) identifying risk factors, symptoms and preventive strategies. A focus on health literacy as practice will include personal engagement using language in context: (1) role-play interactions about lead exposure prevention; (2) discussing views about risk, and how to talk about it with peers and family members; (3) identifying sources of reliable health information; and (4) learning to ask for support and resources.

Sponsors

ACE Community Health
CollaboratorOTHER
Genesee County Hispanic Latino Collaborative
CollaboratorOTHER
National Center for Advancing Translational Sciences (NCATS)
CollaboratorNIH
University of Michigan
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE

Masking description

Investigator

Intervention model description

A pilot trial will be used: study participants will be registered and placed into the program on a first-come, first-served basis. This will result in a study assessing correlation rather than causation.

Eligibility

Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
Yes

Inclusion criteria

* Hispanic immigrants living in or around Flint. * Native speakers of Spanish, with varying degrees of English fluency and literacy. * 18 years old and older.

Exclusion criteria

* Immigrants from other linguistic backgrounds will be excluded at this time because all program materials will be bilingually available in English and Spanish. * Children will be excluded at this time because we are focusing on ESL health literacy for adults.

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants Practicing Safe Lead Exposure Prevention Behaviors (Pre Test)BaselineESL Hispanic adult learners' lead exposure prevention adherence to the evidence-based recommendations set by the Environmental Protection Agency (EPA) and the Centre for Disease Control and Prevention (CDC) for reducing exposure to water containing levels of lead above 15 ppb for the use was measured using a 3 item questionnaire. Questions include: (1) I have had my water tested for lead; (2) I have an NSF approved filter for my drinking water; and (3) I use bottled water or water from a filtration system for drinking and cooking to reduce or eliminate my lead exposure. Response options are yes, no and don't know. The numbers below represent participants who answered 'Yes' to each question.
Number of Participants Practicing Safe Lead Exposure Prevention Behaviors (Post Test)Up to 8-weeks post-treatmentESL Hispanic adult learners' lead exposure prevention adherence to the evidence-based recommendations set by the Environmental Protection Agency (EPA) and the Centre for Disease Control and Prevention (CDC) for reducing exposure to water containing levels of lead above 15 ppb for the use was measured using a 3 item questionnaire. Questions include: (1) I have had my water tested for lead; (2) I have an NSF approved filter for my drinking water; and (3) I use bottled water or water from a filtration system for drinking and cooking to reduce or eliminate my lead exposure. Response options are yes, no and don't know. The numbers below represent participants who answered 'Yes' to each question.

Secondary

MeasureTime frameDescription
Lead Exposure Prevention Knowledge (Pre-Test)BaselineESL Hispanic adult learners' lead exposure prevention knowledge of the evidence-based recommendations set by the EPA and the CDC for reducing exposure to water containing levels of lead above 15 ppb. Numerical score measured by questions on the Chicago Lead Knowledge Test questionnaire. Five questions related to the 24 question Chicago Lead Knowledge test questionnaire were administered to participants. One point was assigned to each correct response. A participant could earn five total points; with five total points meaning all questions were answered correctly. A composite value was created for the 5 questions.
Lead Exposure Prevention Knowledge (Post Test)Up to 8-weeks post-treatmentESL Hispanic adult learners' lead exposure prevention knowledge of the evidence-based recommendations set by the EPA and the CDC for reducing exposure to water containing levels of lead above 15 ppb. Numerical score measured by questions on the Chicago Lead Knowledge Test questionnaire. Five questions related to the 24 question Chicago Lead Knowledge test questionnaire were administered to participants. One point was assigned to each correct response. A participant could earn five total points; with five total points meaning all questions were answered correctly. A composite value was created for the 5 questions.
Health Literacy Level (Pre-Test)BaselineESL Hispanic adult learner's health literacy score. Numerical score measured by questions on the Fostering Literacy for Good Health Today (FLIGHT) Nive Desarollando Amplia Salud (VIDAS) Test. The short 10-question FLIGHT VIDAS test was administered to participants in Spanish. One point was assigned to each correct response. A participant could earn 10 total points. The literacy level scale is: 0-3 below basic, 4-6 basic, 7-8 intermediate, 9-10 proficient.
Health Literacy Level (Post-Test)Up to 8-weeks post-treatmentESL Hispanic adult learner's health literacy score. Numerical score measured by questions on the Fostering Literacy for Good Health Today (FLIGHT) Nive Desarollando Amplia Salud (VIDAS) Test.

Other

MeasureTime frameDescription
Number of Participants With Health Care Coverage as Measured by the Behavioral Risk Factor Surveillance Survey (Pre Test)BaselineESL Hispanic adult learners' were asked to describe their health care coverage status. Numerical score measured by questions on the Behavioral Risk Factor Surveillance Survey. Participants were asked (1) Do you have any kind of health case coverage including health insurance, prepaid plans such as HMOs, or government plans such as Medicare, or Indian Health Service? Responses could include 'Yes', 'No' and 'Don't Know'. The participants who answered 'Yes' are represented below.
Number of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Pre Test)BaselineESL Hispanic adult learners' level of food security was measured using two questions from the National Health and Nutrition Examination Survey. The questions include: (1) In the past 12 months how often did you or anyone else in your household worry there would not be enough to eat because of a lack of money and (2) In the past 12 months how often did you or anyone else in your household not eat quality or variety of foods that you wanted to eat because of a lack of money. Possible response options include 'Often', 'Sometimes', 'Never', 'Don't Know', and 'Refuse to Answer'.
Number of Participants With Health Care Coverage as Measured by the Behavioral Risk Factor Surveillance Survey (Post Test)Up to 8 weeks post-treatmentESL Hispanic adult learners' were asked to describe their health care coverage status. Numerical score measured by questions on the Behavioral Risk Factor Surveillance Survey. Participants were asked (1) Do you have any kind of health case coverage including health insurance, prepaid plans such as HMOs, or government plans such as Medicare, or Indian Health Service? Responses could include 'Yes', 'No' and 'Don't Know'. The participants who answered 'Yes' are represented below.
Number of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Post Test)Up to 8 weeks post treatmentESL Hispanic adult learners' level of food security was measured using two questions from the National Health and Nutrition Examination Survey. The questions include: (1) In the past 12 months how often did you or anyone else in your household worry there would not be enough to eat because of a lack of money and (2) In the past 12 months how often did you or anyone else in your household not eat quality or variety of foods that you wanted to eat because of a lack of money. Possible response options include 'Often', 'Sometimes', 'Never', 'Don't Know', and 'Refuse to Answer'.
Number of Participants Able to Obtain Health Information as Measured by the National Health and Nutrition Examination Survey (Pre Test)BaselineESL Hispanic adult learners' completed three questions to evaluate their ability to obtain health information. Three questions taken from the National Health and Nutrition Examination Survey were administered to participants. Questions include (1) In the past 12 months did you do anything to improve your health (2) In the past 12 months have you required health information or advice for yourself or a family member and (3) In the past 12 months did you ever experience any difficulties getting the health information or advice for yourself or a family member. Response options are yes, no and don't know. The numbers below represent participants who answered 'Yes' to each question.
Number of Participants Able to Obtain Health Information as Measured by the National Health and Nutrition Examination Survey (Post Test)Up to 8-weeks post-treatmentESL Hispanic adult learners' completed three questions to evaluate their ability to obtain health information. Three questions taken from the National Health and Nutrition Examination Survey were administered to participants. Questions include (1) In the past 12 months did you do anything to improve your health (2) In the past 12 months have you required health information or advice for yourself or a family member and (3) In the past 12 months did you ever experience any difficulties getting the health information or advice for yourself or a family member. Response options are yes, no and don't know. The numbers below represent participants who answered 'Yes' to each question.
Perception of Community Belonging as Measured by the National Health and Nutrition Examination Survey (Pre Test)BaselineESL Hispanic adult learners' were asked to describe their sense of belonging to thier local community. Participants were asked to complete a question taken from the National Health and Nutrition Examination Survey asking them to rate their sense of belonging to their local community from 'very strong' (1) to 'very weak' (4). Responses could include 'very strong','somewhat strong', 'somewhat weak', 'very weak', 'don't know', and 'refuse to answer'. The numbers below represent the participants who selected each response.
Perception of Community Belonging as Measured by the National Health and Nutrition Examination Survey (Post Test)Up to 8 weeks post treatmentESL Hispanic adult learners' were asked to describe their sense of belonging to thier local community. Participants were asked to complete a question taken from the National Health and Nutrition Examination Survey asking them to rate their sense of belonging to their local community from 'very strong' (1) to 'very weak' (4). Responses could include 'very strong','somewhat strong', 'somewhat weak', 'very weak', 'don't know', and 'refuse to answer'. The numbers below represent the participants who selected each response.

Countries

United States

Participant flow

Participants by arm

ArmCount
ESL Health Literacy Classes
The program will last 5-8 weeks with classes held online during evening hours. The curriculum will focus on using pedagogies for health literacy as a practice. Assessments will be administered pre-post intervention. ESL Health Literacy Classes: The intervention will last 5-8 weeks, and the first and last classes will be devoted to survey assessments. Participants will be asked to reflect on their health knowledge and behaviors, and how they have changed since starting the program. The curriculum administered during the classes will use pedagogies for health literacy as a practice. It will focus on skills needed to learn about lead exposure in the ESL classroom: (1) vocabulary; (2) grammar; and (3) identifying risk factors, symptoms and preventive strategies. A focus on health literacy as practice will include personal engagement using language in context: (1) role-play interactions about lead exposure prevention; (2) discussing views about risk, and how to talk about it with peers and family members; (3) identifying sources of reliable health information; and (4) learning to ask for support and resources.
17
Total17

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyLost to Follow-up15

Baseline characteristics

CharacteristicESL Health Literacy Classes
Age, Continuous42.21 years
STANDARD_DEVIATION 9.77
Ethnicity (NIH/OMB)
Hispanic or Latino
17 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
0 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
Sex: Female, Male
Female
17 Participants
Sex: Female, Male
Male
0 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 17
other
Total, other adverse events
0 / 17
serious
Total, serious adverse events
0 / 17

Outcome results

Primary

Number of Participants Practicing Safe Lead Exposure Prevention Behaviors (Post Test)

ESL Hispanic adult learners' lead exposure prevention adherence to the evidence-based recommendations set by the Environmental Protection Agency (EPA) and the Centre for Disease Control and Prevention (CDC) for reducing exposure to water containing levels of lead above 15 ppb for the use was measured using a 3 item questionnaire. Questions include: (1) I have had my water tested for lead; (2) I have an NSF approved filter for my drinking water; and (3) I use bottled water or water from a filtration system for drinking and cooking to reduce or eliminate my lead exposure. Response options are yes, no and don't know. The numbers below represent participants who answered 'Yes' to each question.

Time frame: Up to 8-weeks post-treatment

Population: Five people participated in the health literacy curriculum which is where this outcome was measured.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
ESL Health Literacy ClassesNumber of Participants Practicing Safe Lead Exposure Prevention Behaviors (Post Test)I have had my water tested for lead.3 Participants
ESL Health Literacy ClassesNumber of Participants Practicing Safe Lead Exposure Prevention Behaviors (Post Test)I have an NSF-approved filter for my drinking water.5 Participants
ESL Health Literacy ClassesNumber of Participants Practicing Safe Lead Exposure Prevention Behaviors (Post Test)I use bottled water or water from a filtration system to reduce or eliminate my lead exposure5 Participants
Primary

Number of Participants Practicing Safe Lead Exposure Prevention Behaviors (Pre Test)

ESL Hispanic adult learners' lead exposure prevention adherence to the evidence-based recommendations set by the Environmental Protection Agency (EPA) and the Centre for Disease Control and Prevention (CDC) for reducing exposure to water containing levels of lead above 15 ppb for the use was measured using a 3 item questionnaire. Questions include: (1) I have had my water tested for lead; (2) I have an NSF approved filter for my drinking water; and (3) I use bottled water or water from a filtration system for drinking and cooking to reduce or eliminate my lead exposure. Response options are yes, no and don't know. The numbers below represent participants who answered 'Yes' to each question.

Time frame: Baseline

Population: Five people participated in the health literacy curriculum which is where this outcome was measured.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
ESL Health Literacy ClassesNumber of Participants Practicing Safe Lead Exposure Prevention Behaviors (Pre Test)I have had my water tested for lead.1 Participants
ESL Health Literacy ClassesNumber of Participants Practicing Safe Lead Exposure Prevention Behaviors (Pre Test)I have an NSF-approved filter for my drinking water.2 Participants
ESL Health Literacy ClassesNumber of Participants Practicing Safe Lead Exposure Prevention Behaviors (Pre Test)I use bottled water or water from a filtration system to reduce or eliminate my lead exposure5 Participants
Secondary

Health Literacy Level (Post-Test)

ESL Hispanic adult learner's health literacy score. Numerical score measured by questions on the Fostering Literacy for Good Health Today (FLIGHT) Nive Desarollando Amplia Salud (VIDAS) Test.

Time frame: Up to 8-weeks post-treatment

Population: Responses to the post test literacy questions not available because the FLIGHT/VIDAS was a separate test and the post test was not administered due to study team oversight.

Secondary

Health Literacy Level (Pre-Test)

ESL Hispanic adult learner's health literacy score. Numerical score measured by questions on the Fostering Literacy for Good Health Today (FLIGHT) Nive Desarollando Amplia Salud (VIDAS) Test. The short 10-question FLIGHT VIDAS test was administered to participants in Spanish. One point was assigned to each correct response. A participant could earn 10 total points. The literacy level scale is: 0-3 below basic, 4-6 basic, 7-8 intermediate, 9-10 proficient.

Time frame: Baseline

ArmMeasureCategoryValue (COUNT_OF_PARTICIPANTS)
ESL Health Literacy ClassesHealth Literacy Level (Pre-Test)Basic literacy (4-6 correct answers)5 Participants
ESL Health Literacy ClassesHealth Literacy Level (Pre-Test)Below basic literacy (0-3 correct answers)3 Participants
ESL Health Literacy ClassesHealth Literacy Level (Pre-Test)Intermediate literacy (7-8 correct answers)3 Participants
ESL Health Literacy ClassesHealth Literacy Level (Pre-Test)Proficient literacy (9-10 correct answers)6 Participants
Secondary

Lead Exposure Prevention Knowledge (Post Test)

ESL Hispanic adult learners' lead exposure prevention knowledge of the evidence-based recommendations set by the EPA and the CDC for reducing exposure to water containing levels of lead above 15 ppb. Numerical score measured by questions on the Chicago Lead Knowledge Test questionnaire. Five questions related to the 24 question Chicago Lead Knowledge test questionnaire were administered to participants. One point was assigned to each correct response. A participant could earn five total points; with five total points meaning all questions were answered correctly. A composite value was created for the 5 questions.

Time frame: Up to 8-weeks post-treatment

Population: Only two participants were administered and completed the post test. Due to the COVID-19 pandemic overall enrollment in the study was low and several participants withdrew from the study.

ArmMeasureValue (MEAN)Dispersion
ESL Health Literacy ClassesLead Exposure Prevention Knowledge (Post Test)4 units on a scaleStandard Deviation 0
Secondary

Lead Exposure Prevention Knowledge (Pre-Test)

ESL Hispanic adult learners' lead exposure prevention knowledge of the evidence-based recommendations set by the EPA and the CDC for reducing exposure to water containing levels of lead above 15 ppb. Numerical score measured by questions on the Chicago Lead Knowledge Test questionnaire. Five questions related to the 24 question Chicago Lead Knowledge test questionnaire were administered to participants. One point was assigned to each correct response. A participant could earn five total points; with five total points meaning all questions were answered correctly. A composite value was created for the 5 questions.

Time frame: Baseline

ArmMeasureValue (MEAN)Dispersion
ESL Health Literacy ClassesLead Exposure Prevention Knowledge (Pre-Test)3.35 units on a scaleStandard Deviation 0.86
Other Pre-specified

Number of Participants Able to Obtain Health Information as Measured by the National Health and Nutrition Examination Survey (Post Test)

ESL Hispanic adult learners' completed three questions to evaluate their ability to obtain health information. Three questions taken from the National Health and Nutrition Examination Survey were administered to participants. Questions include (1) In the past 12 months did you do anything to improve your health (2) In the past 12 months have you required health information or advice for yourself or a family member and (3) In the past 12 months did you ever experience any difficulties getting the health information or advice for yourself or a family member. Response options are yes, no and don't know. The numbers below represent participants who answered 'Yes' to each question.

Time frame: Up to 8-weeks post-treatment

Population: Only two participants were administered and completed the post test. Due to the COVID-19 pandemic overall enrollment in the study was low and several participants withdrew from the study.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
ESL Health Literacy ClassesNumber of Participants Able to Obtain Health Information as Measured by the National Health and Nutrition Examination Survey (Post Test)Did you do anything to improve your health?0 Participants
ESL Health Literacy ClassesNumber of Participants Able to Obtain Health Information as Measured by the National Health and Nutrition Examination Survey (Post Test)Have you required health information or advice for yourself or a family member?0 Participants
ESL Health Literacy ClassesNumber of Participants Able to Obtain Health Information as Measured by the National Health and Nutrition Examination Survey (Post Test)Did you ever experience any difficulties getting the health information or advice0 Participants
Other Pre-specified

Number of Participants Able to Obtain Health Information as Measured by the National Health and Nutrition Examination Survey (Pre Test)

ESL Hispanic adult learners' completed three questions to evaluate their ability to obtain health information. Three questions taken from the National Health and Nutrition Examination Survey were administered to participants. Questions include (1) In the past 12 months did you do anything to improve your health (2) In the past 12 months have you required health information or advice for yourself or a family member and (3) In the past 12 months did you ever experience any difficulties getting the health information or advice for yourself or a family member. Response options are yes, no and don't know. The numbers below represent participants who answered 'Yes' to each question.

Time frame: Baseline

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
ESL Health Literacy ClassesNumber of Participants Able to Obtain Health Information as Measured by the National Health and Nutrition Examination Survey (Pre Test)Did you do anything to improve your health?9 Participants
ESL Health Literacy ClassesNumber of Participants Able to Obtain Health Information as Measured by the National Health and Nutrition Examination Survey (Pre Test)Have you required health information or advice for yourself or a family member?8 Participants
ESL Health Literacy ClassesNumber of Participants Able to Obtain Health Information as Measured by the National Health and Nutrition Examination Survey (Pre Test)Did you ever experience any difficulties getting the health information or advice5 Participants
Other Pre-specified

Number of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Post Test)

ESL Hispanic adult learners' level of food security was measured using two questions from the National Health and Nutrition Examination Survey. The questions include: (1) In the past 12 months how often did you or anyone else in your household worry there would not be enough to eat because of a lack of money and (2) In the past 12 months how often did you or anyone else in your household not eat quality or variety of foods that you wanted to eat because of a lack of money. Possible response options include 'Often', 'Sometimes', 'Never', 'Don't Know', and 'Refuse to Answer'.

Time frame: Up to 8 weeks post treatment

Population: Only two participants were administered and completed the post test. Due to the COVID-19 pandemic overall enrollment in the study was low and several participants withdrew from the study.

ArmMeasureGroupCategoryValue (COUNT_OF_PARTICIPANTS)
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Post Test)How often did you worry that there would not be enough to eat because of a lack of money?Often0 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Post Test)How often did you worry that there would not be enough to eat because of a lack of money?Sometimes0 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Post Test)How often did you worry that there would not be enough to eat because of a lack of money?Never2 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Post Test)How often did you worry that there would not be enough to eat because of a lack of money?Don't Know0 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Post Test)How often did you worry that there would not be enough to eat because of a lack of money?Refuse0 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Post Test)How often did you not eat the quality or variety of foods because of a lack of money?Often0 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Post Test)How often did you not eat the quality or variety of foods because of a lack of money?Sometimes0 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Post Test)How often did you not eat the quality or variety of foods because of a lack of money?Never2 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Post Test)How often did you not eat the quality or variety of foods because of a lack of money?Don't Know0 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Post Test)How often did you not eat the quality or variety of foods because of a lack of money?Refuse0 Participants
Other Pre-specified

Number of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Pre Test)

ESL Hispanic adult learners' level of food security was measured using two questions from the National Health and Nutrition Examination Survey. The questions include: (1) In the past 12 months how often did you or anyone else in your household worry there would not be enough to eat because of a lack of money and (2) In the past 12 months how often did you or anyone else in your household not eat quality or variety of foods that you wanted to eat because of a lack of money. Possible response options include 'Often', 'Sometimes', 'Never', 'Don't Know', and 'Refuse to Answer'.

Time frame: Baseline

ArmMeasureGroupCategoryValue (COUNT_OF_PARTICIPANTS)
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Pre Test)How often did you worry that there would not be enough to eat because of a lack of money?Often0 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Pre Test)How often did you worry that there would not be enough to eat because of a lack of money?Sometimes9 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Pre Test)How often did you worry that there would not be enough to eat because of a lack of money?Never4 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Pre Test)How often did you worry that there would not be enough to eat because of a lack of money?Don't Know0 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Pre Test)How often did you worry that there would not be enough to eat because of a lack of money?Refuse4 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Pre Test)How often did you not eat the quality or variety of foods because of a lack of money?Often0 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Pre Test)How often did you not eat the quality or variety of foods because of a lack of money?Sometimes4 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Pre Test)How often did you not eat the quality or variety of foods because of a lack of money?Never9 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Pre Test)How often did you not eat the quality or variety of foods because of a lack of money?Don't Know0 Participants
ESL Health Literacy ClassesNumber of Participants Who Experienced Food Insecurity as Measured by the National Health and Nutrition Examination Survey (Pre Test)How often did you not eat the quality or variety of foods because of a lack of money?Refuse4 Participants
Other Pre-specified

Number of Participants With Health Care Coverage as Measured by the Behavioral Risk Factor Surveillance Survey (Post Test)

ESL Hispanic adult learners' were asked to describe their health care coverage status. Numerical score measured by questions on the Behavioral Risk Factor Surveillance Survey. Participants were asked (1) Do you have any kind of health case coverage including health insurance, prepaid plans such as HMOs, or government plans such as Medicare, or Indian Health Service? Responses could include 'Yes', 'No' and 'Don't Know'. The participants who answered 'Yes' are represented below.

Time frame: Up to 8 weeks post-treatment

Population: Only two participants were administered and completed the post test. Due to the COVID-19 pandemic overall enrollment in the study was low and several participants withdrew from the study.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
ESL Health Literacy ClassesNumber of Participants With Health Care Coverage as Measured by the Behavioral Risk Factor Surveillance Survey (Post Test)2 Participants
Other Pre-specified

Number of Participants With Health Care Coverage as Measured by the Behavioral Risk Factor Surveillance Survey (Pre Test)

ESL Hispanic adult learners' were asked to describe their health care coverage status. Numerical score measured by questions on the Behavioral Risk Factor Surveillance Survey. Participants were asked (1) Do you have any kind of health case coverage including health insurance, prepaid plans such as HMOs, or government plans such as Medicare, or Indian Health Service? Responses could include 'Yes', 'No' and 'Don't Know'. The participants who answered 'Yes' are represented below.

Time frame: Baseline

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
ESL Health Literacy ClassesNumber of Participants With Health Care Coverage as Measured by the Behavioral Risk Factor Surveillance Survey (Pre Test)7 Participants
Other Pre-specified

Perception of Community Belonging as Measured by the National Health and Nutrition Examination Survey (Post Test)

ESL Hispanic adult learners' were asked to describe their sense of belonging to thier local community. Participants were asked to complete a question taken from the National Health and Nutrition Examination Survey asking them to rate their sense of belonging to their local community from 'very strong' (1) to 'very weak' (4). Responses could include 'very strong','somewhat strong', 'somewhat weak', 'very weak', 'don't know', and 'refuse to answer'. The numbers below represent the participants who selected each response.

Time frame: Up to 8 weeks post treatment

Population: Only two participants were administered and completed the post test. Due to the COVID-19 pandemic overall enrollment in the study was low and several participants withdrew from the study.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
ESL Health Literacy ClassesPerception of Community Belonging as Measured by the National Health and Nutrition Examination Survey (Post Test)Very Stong0 Participants
ESL Health Literacy ClassesPerception of Community Belonging as Measured by the National Health and Nutrition Examination Survey (Post Test)Somewhat Strong0 Participants
ESL Health Literacy ClassesPerception of Community Belonging as Measured by the National Health and Nutrition Examination Survey (Post Test)Somewhat Weak1 Participants
ESL Health Literacy ClassesPerception of Community Belonging as Measured by the National Health and Nutrition Examination Survey (Post Test)Very Weak0 Participants
ESL Health Literacy ClassesPerception of Community Belonging as Measured by the National Health and Nutrition Examination Survey (Post Test)Don't Know0 Participants
ESL Health Literacy ClassesPerception of Community Belonging as Measured by the National Health and Nutrition Examination Survey (Post Test)Refused to Answer1 Participants
Other Pre-specified

Perception of Community Belonging as Measured by the National Health and Nutrition Examination Survey (Pre Test)

ESL Hispanic adult learners' were asked to describe their sense of belonging to thier local community. Participants were asked to complete a question taken from the National Health and Nutrition Examination Survey asking them to rate their sense of belonging to their local community from 'very strong' (1) to 'very weak' (4). Responses could include 'very strong','somewhat strong', 'somewhat weak', 'very weak', 'don't know', and 'refuse to answer'. The numbers below represent the participants who selected each response.

Time frame: Baseline

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
ESL Health Literacy ClassesPerception of Community Belonging as Measured by the National Health and Nutrition Examination Survey (Pre Test)Very Strong0 Participants
ESL Health Literacy ClassesPerception of Community Belonging as Measured by the National Health and Nutrition Examination Survey (Pre Test)Somewhat Strong2 Participants
ESL Health Literacy ClassesPerception of Community Belonging as Measured by the National Health and Nutrition Examination Survey (Pre Test)Somewhat Weak1 Participants
ESL Health Literacy ClassesPerception of Community Belonging as Measured by the National Health and Nutrition Examination Survey (Pre Test)Very Weak10 Participants
ESL Health Literacy ClassesPerception of Community Belonging as Measured by the National Health and Nutrition Examination Survey (Pre Test)Don't Know1 Participants
ESL Health Literacy ClassesPerception of Community Belonging as Measured by the National Health and Nutrition Examination Survey (Pre Test)Refused to Answer3 Participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026